Resumen

HIRSCHLER, Valeria et al. ¿Es la circunferencia de cintura un componente del síndrome metabólico en la infancia?. Arch. argent. pediatr. [online]. 2005, vol.103, n.1, pp.7-13. ISSN 0325-0075.

Objective. To determine a) the association between waist circumference (WC) and insulin-resistance determined by homeostasis modeling (HOMA-IR) and proinsulinemia, lipid profile and blood pressure (BP) in children. Population, material and methods. 2,182 (1,126 male) students, aged 6 to 13 years, underwent anthropometric measurements, and 68 children -40 obese (OB)- and 28 overwight were randomized for more extensive testing, as well as 16 non-obese children matched for age and sex. Body mass index (BMI), WC, BP, and Tanner stage were determined in all subjects. The subgroup had oral glucose tolerance testing (OGTT), lipid profile, insulinemia and proinsulinemia assays. Children were classified as non-OB (BMI <85 percentile), overweighted (BMI between 85 and 94 percentile) and OB (BMI >95 percentile). Results. There was a univariate association between WC and height (r= 0.73), BMI (r= 0.96), Tanner stage (r= 0.67), age (r= 0.56), BMI (r= 0.96), systolic BP (r= 0.64), diastolic BP (r= 0.61), HDL (r= 0.45), triglycerides (r= 0.28), proinsulin (r= 0.59), and HOMA-IR (r= 0.59). Logistic regression analysis using WC >90º percentile (yes or no) as the dependent variable showed that HDL (Exp Beta 0.93, 95% CI 0.88-0.98, P= 0.01) and HOMA-IR (Exp Beta= 1.997, 95% CI 1.174-3.396) were significant independent risk factors for WC after adjusting for age as well as for Tanner stage, sex, height, blood pressure and triglycerides. Multiple linear regression analysis using HOMAIR as the dependent variable showed that WC (beta coefficient= 0.066 CI 95%: 0.007 - 0.125; P= 0.029), age (-0.389 CI 95%-0.611-/ -0.167; P= 0.001), and Tanner stage (0.734 CI 95%0.175/1.29; P= 0.011 respectively) were significant independent predictors for insulin resistance. Conclusion. WC is a predictor of the insulin-resistance syndrome in children and adolescents, and could be included in clinical practice as a simple tool to identify children at risk for future cardiovascular disease and T2DM.

Palabras clave : Obesity; Insulin-resistance; Waist circumference.

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